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10:35
Microvascular Decompression: Salient Surgical Principles and Technical Nuances
Published on: July 5, 2011
Institutional experience with cranial vault encephaloceles.
Cuong J Bui1, R Shane Tubbs, Chevis N Shannon
1Section of Pediatric Neurosurgery, University of Alabama at Birmingham, and Children's Hospital, Birmingham, Alabama 35233, USA.
Journal of Neurosurgery
|July 25, 2007
Summary
Occipital encephaloceles have worse outcomes than frontal ones, often leading to hydrocephalus and epilepsy. Many patients with occipital encephaloceles face severe debilitation and dependence.
Area of Science:
- Neurosurgery
- Pediatric Neurology
- Developmental Neuroscience
Background:
- Limited data exists on long-term outcomes for cranial vault encephalocele patients.
- Existing literature may underestimate long-term neurological deficits.
Purpose of the Study:
- To investigate the long-term outcomes of patients with cranial vault encephaloceles.
- To identify prognostic factors influencing patient recovery and quality of life.
Main Methods:
- Retrospective chart review of 44 cranial vault encephalocele cases (1989-2003).
- Outcome assessment via Hydrocephalus Outcome Questionnaire (HOQ) for 34 patients.
- Evaluation of physical, emotional, cognitive, and overall health outcomes.
Main Results:
- Occipital encephaloceles showed higher rates of hydrocephalus (60%) and epilepsy (17%) compared to frontal.
- 50% of occipital encephalocele patients had poor overall HOQ scores (<0.5), and 55% had poor cognitive scores (<0.3).
- Hydrocephalus and epilepsy were significant independent predictors of lower overall health scores.
Conclusions:
- Occipital encephaloceles are associated with a poorer prognosis than frontal encephaloceles.
- Hydrocephalus and epilepsy are significant additive adverse prognostic factors.
- Nearly half of occipital encephalocele patients may experience severe debilitation, impacting independent living.
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